| NPI | 1295183184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: CO DR.0069230) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125.068578) |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2022-08-19 |